%0 Journal Article %J Quality of Life Research %D 2007 %T Developing tailored instruments: item banking and computerized adaptive assessment %A Bjorner, J. B. %A Chang, C-H. %A Thissen, D. %A Reeve, B. B. %K *Health Status %K *Health Status Indicators %K *Mental Health %K *Outcome Assessment (Health Care) %K *Quality of Life %K *Questionnaires %K *Software %K Algorithms %K Factor Analysis, Statistical %K Humans %K Models, Statistical %K Psychometrics %X Item banks and Computerized Adaptive Testing (CAT) have the potential to greatly improve the assessment of health outcomes. This review describes the unique features of item banks and CAT and discusses how to develop item banks. In CAT, a computer selects the items from an item bank that are most relevant for and informative about the particular respondent; thus optimizing test relevance and precision. Item response theory (IRT) provides the foundation for selecting the items that are most informative for the particular respondent and for scoring responses on a common metric. The development of an item bank is a multi-stage process that requires a clear definition of the construct to be measured, good items, a careful psychometric analysis of the items, and a clear specification of the final CAT. The psychometric analysis needs to evaluate the assumptions of the IRT model such as unidimensionality and local independence; that the items function the same way in different subgroups of the population; and that there is an adequate fit between the data and the chosen item response models. Also, interpretation guidelines need to be established to help the clinical application of the assessment. Although medical research can draw upon expertise from educational testing in the development of item banks and CAT, the medical field also encounters unique opportunities and challenges. %B Quality of Life Research %7 2007/05/29 %V 16 %P 95-108 %@ 0962-9343 (Print) %G eng %M 17530450 %0 Journal Article %J Quality of Life Research %D 2007 %T IRT health outcomes data analysis project: an overview and summary %A Cook, K. F. %A Teal, C. R. %A Bjorner, J. B. %A Cella, D. %A Chang, C-H. %A Crane, P. K. %A Gibbons, L. E. %A Hays, R. D. %A McHorney, C. A. %A Ocepek-Welikson, K. %A Raczek, A. E. %A Teresi, J. A. %A Reeve, B. B. %K *Data Interpretation, Statistical %K *Health Status %K *Quality of Life %K *Questionnaires %K *Software %K Female %K HIV Infections/psychology %K Humans %K Male %K Neoplasms/psychology %K Outcome Assessment (Health Care)/*methods %K Psychometrics %K Stress, Psychological %X BACKGROUND: In June 2004, the National Cancer Institute and the Drug Information Association co-sponsored the conference, "Improving the Measurement of Health Outcomes through the Applications of Item Response Theory (IRT) Modeling: Exploration of Item Banks and Computer-Adaptive Assessment." A component of the conference was presentation of a psychometric and content analysis of a secondary dataset. OBJECTIVES: A thorough psychometric and content analysis was conducted of two primary domains within a cancer health-related quality of life (HRQOL) dataset. RESEARCH DESIGN: HRQOL scales were evaluated using factor analysis for categorical data, IRT modeling, and differential item functioning analyses. In addition, computerized adaptive administration of HRQOL item banks was simulated, and various IRT models were applied and compared. SUBJECTS: The original data were collected as part of the NCI-funded Quality of Life Evaluation in Oncology (Q-Score) Project. A total of 1,714 patients with cancer or HIV/AIDS were recruited from 5 clinical sites. MEASURES: Items from 4 HRQOL instruments were evaluated: Cancer Rehabilitation Evaluation System-Short Form, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, Functional Assessment of Cancer Therapy and Medical Outcomes Study Short-Form Health Survey. RESULTS AND CONCLUSIONS: Four lessons learned from the project are discussed: the importance of good developmental item banks, the ambiguity of model fit results, the limits of our knowledge regarding the practical implications of model misfit, and the importance in the measurement of HRQOL of construct definition. With respect to these lessons, areas for future research are suggested. The feasibility of developing item banks for broad definitions of health is discussed. %B Quality of Life Research %7 2007/03/14 %V 16 %P 121-132 %@ 0962-9343 (Print) %G eng %M 17351824 %0 Journal Article %J Quality of Life Research %D 2007 %T Methodological issues for building item banks and computerized adaptive scales %A Thissen, D. %A Reeve, B. B. %A Bjorner, J. B. %A Chang, C-H. %X Abstract This paper reviews important methodological considerations for developing item banks and computerized adaptive scales (commonly called computerized adaptive tests in the educational measurement literature, yielding the acronym CAT), including issues of the reference population, dimensionality, dichotomous versus polytomous response scales, differential item functioning (DIF) and conditional scoring, mode effects, the impact of local dependence, and innovative approaches to assessment using CATs in health outcomes research. %B Quality of Life Research %V 16 %P 109-119, %@ 0962-93431573-2649 %G eng %0 Journal Article %J Medical Care %D 2007 %T Psychometric evaluation and calibration of health-related quality of life item banks: plans for the Patient-Reported Outcomes Measurement Information System (PROMIS) %A Reeve, B. B. %A Hays, R. D. %A Bjorner, J. B. %A Cook, K. F. %A Crane, P. K. %A Teresi, J. A. %A Thissen, D. %A Revicki, D. A. %A Weiss, D. J. %A Hambleton, R. K. %A Liu, H. %A Gershon, R. C. %A Reise, S. P. %A Lai, J. S. %A Cella, D. %K *Health Status %K *Information Systems %K *Quality of Life %K *Self Disclosure %K Adolescent %K Adult %K Aged %K Calibration %K Databases as Topic %K Evaluation Studies as Topic %K Female %K Humans %K Male %K Middle Aged %K Outcome Assessment (Health Care)/*methods %K Psychometrics %K Questionnaires/standards %K United States %X BACKGROUND: The construction and evaluation of item banks to measure unidimensional constructs of health-related quality of life (HRQOL) is a fundamental objective of the Patient-Reported Outcomes Measurement Information System (PROMIS) project. OBJECTIVES: Item banks will be used as the foundation for developing short-form instruments and enabling computerized adaptive testing. The PROMIS Steering Committee selected 5 HRQOL domains for initial focus: physical functioning, fatigue, pain, emotional distress, and social role participation. This report provides an overview of the methods used in the PROMIS item analyses and proposed calibration of item banks. ANALYSES: Analyses include evaluation of data quality (eg, logic and range checking, spread of response distribution within an item), descriptive statistics (eg, frequencies, means), item response theory model assumptions (unidimensionality, local independence, monotonicity), model fit, differential item functioning, and item calibration for banking. RECOMMENDATIONS: Summarized are key analytic issues; recommendations are provided for future evaluations of item banks in HRQOL assessment. %B Medical Care %7 2007/04/20 %V 45 %P S22-31 %8 May %@ 0025-7079 (Print) %G eng %M 17443115 %0 Journal Article %J Evaluation and the Health Professions %D 2005 %T Data pooling and analysis to build a preliminary item bank: an example using bowel function in prostate cancer %A Eton, D. T. %A Lai, J. S. %A Cella, D. %A Reeve, B. B. %A Talcott, J. A. %A Clark, J. A. %A McPherson, C. P. %A Litwin, M. S. %A Moinpour, C. M. %K *Quality of Life %K *Questionnaires %K Adult %K Aged %K Data Collection/methods %K Humans %K Intestine, Large/*physiopathology %K Male %K Middle Aged %K Prostatic Neoplasms/*physiopathology %K Psychometrics %K Research Support, Non-U.S. Gov't %K Statistics, Nonparametric %X Assessing bowel function (BF) in prostate cancer can help determine therapeutic trade-offs. We determined the components of BF commonly assessed in prostate cancer studies as an initial step in creating an item bank for clinical and research application. We analyzed six archived data sets representing 4,246 men with prostate cancer. Thirty-one items from validated instruments were available for analysis. Items were classified into domains (diarrhea, rectal urgency, pain, bleeding, bother/distress, and other) then subjected to conventional psychometric and item response theory (IRT) analyses. Items fit the IRT model if the ratio between observed and expected item variance was between 0.60 and 1.40. Four of 31 items had inadequate fit in at least one analysis. Poorly fitting items included bleeding (2), rectal urgency (1), and bother/distress (1). A fifth item assessing hemorrhoids was poorly correlated with other items. Our analyses supported four related components of BF: diarrhea, rectal urgency, pain, and bother/distress. %B Evaluation and the Health Professions %V 28 %P 142-59 %G eng %M 15851770 %0 Journal Article %J Journal of Pain and Symptom Management %D 2005 %T An item response theory-based pain item bank can enhance measurement precision %A Lai, J-S. %A Dineen, K. %A Reeve, B. B. %A Von Roenn, J. %A Shervin, D. %A McGuire, M. %A Bode, R. K. %A Paice, J. %A Cella, D. %K computerized adaptive testing %X Cancer-related pain is often under-recognized and undertreated. This is partly due to the lack of appropriate assessments, which need to be comprehensive and precise yet easily integrated into clinics. Computerized adaptive testing (CAT) can enable precise-yet-brief assessments by only selecting the most informative items from a calibrated item bank. The purpose of this study was to create such a bank. The sample included 400 cancer patients who were asked to complete 61 pain-related items. Data were analyzed using factor analysis and the Rasch model. The final bank consisted of 43 items which satisfied the measurement requirement of factor analysis and the Rasch model, demonstrated high internal consistency and reasonable item-total correlations, and discriminated patients with differing degrees of pain. We conclude that this bank demonstrates good psychometric properties, is sensitive to pain reported by patients, and can be used as the foundation for a CAT pain-testing platform for use in clinical practice. %B Journal of Pain and Symptom Management %V 30 %P 278-88 %G eng %M 16183012 %0 Journal Article %J Drug and Alcohol Dependence %D 2002 %T Assessing tobacco beliefs among youth using item response theory models %A Panter, A. T. %A Reeve, B. B. %K *Attitude to Health %K *Culture %K *Health Behavior %K *Questionnaires %K Adolescent %K Adult %K Child %K Female %K Humans %K Male %K Models, Statistical %K Smoking/*epidemiology %X Successful intervention research programs to prevent adolescent smoking require well-chosen, psychometrically sound instruments for assessing smoking prevalence and attitudes. Twelve thousand eight hundred and ten adolescents were surveyed about their smoking beliefs as part of the Teenage Attitudes and Practices Survey project, a prospective cohort study of predictors of smoking initiation among US adolescents. Item response theory (IRT) methods are used to frame a discussion of questions that a researcher might ask when selecting an optimal item set. IRT methods are especially useful for choosing items during instrument development, trait scoring, evaluating item functioning across groups, and creating optimal item subsets for use in specialized applications such as computerized adaptive testing. Data analytic steps for IRT modeling are reviewed for evaluating item quality and differential item functioning across subgroups of gender, age, and smoking status. Implications and challenges in the use of these methods for tobacco onset research and for assessing the developmental trajectories of smoking among youth are discussed. %B Drug and Alcohol Dependence %V 68 %P S21-S39 %8 Nov %G eng %M 12324173